Statements Attributable To The Mayo Clinic and The American Academy of Orthopedic Surgeons.

1. Statements attributable to The American Academy of Orthopedic Surgeons:

(a) "...you may need to take the supplements (referring to glucosamine and chondroitin) for a couple of months before you see any results..."

[See: http://orthoinfo.aaos.org/topic.cfm?topic=A00189 Viewed 23 October 2009]

(b) "The American Academy of Orthopedic Surgeons adds that recent studies appear to support the idea that glucosamine and chondroitin relieve osteoarthritis pain".

[See: "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009]

2. Statements attributable to The Mayo Clinic:

(a) "The consensus of expert and industry opinion supports the use of chondroitin and its common partner agent, glucosamine, for improving symptoms and stopping (or possibly reversing) the degenerative process of osteoarthritis."

[See: "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009]

What is JoMo

1. Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT).

The National Institutes of Health funded a large-scale, 4-year study that looked at the ability of glucosamine and chondroitin to reduce the pain of osteoarthritis: the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT).1 "Among the participants in the moderate-to-severe pain group, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared to placebo".

Continued analysis of the GAIT study found that the volunteers who were receiving chondroitin had "a statistically significant improvement in knee joint swelling," and that this seemed to occur more often in those who began the study with milder pain.2

2. Kahan A. STOPP (STudy on Osteoarthritis Progression Prevention).

New Study Shows that Chondroitins 4 and 6 Sulfate Retard Progression of Disease and Alleviates Pain in Patients with Knee Osteoarthritis
PARIS, February 20, 2009—

Top-level experts of musculoskeletal rheumatic diseases commented on results of the Study on Osteoarthritis Progression Prevention (STOPP) showing marked benefits of treatment with chondroitins 4 and 6 sulfate (CS) in patients suffering from knee osteoarthritis (OA). The study provided compelling evidence that CS significantly retard join structure degradation while providing symptomatic relief to treated patients.

This international, randomized, double-blind, placebo-controlled study was conducted in 622 patients aged 45 to 80 years with knee OA. Patients received either an 800-mg sachet of highly purified CS (Genévrier Laboratories, Sophia Antipolis, France, and IBSA, Pambio Noranco, Switzerland) (n = 309 patients) or placebo (n = 313 patients) once daily for 2 years.

"Both ITT and per protocol analyses show that CS significantly retard joint structure degradation"

The intent-to-treat analysis demonstrated:

• A significant reduction (P < 0.0001) in minimum JSW loss in the CS group (0.07± 0.03 mm versus 0.31± 0.04 mm) (Figure 1). Of note, the effect of treatment significantly increased with time.
• A significant reduction (P < 0.0005) of the percentage of patients with radiographic
  progression >0.25 mm in the CS group (28% versus 41%; relative risk reduction 33% [95% confidence interval 16-46%]). A significant reduction of JSW loss was observed with any threshold between 0.05 mm and 0.7 mm. For example, fewer patients experienced JSW loss of at least 0.5 mm with CS as compared to placebo (13% versus 27%, respectively; P<0.0001).

"Rapid and long-lasting improvement of pain"

The ITT analysis (VAS and WOMAC) demonstrated significantly faster improvement in pain in the CS group than in the placebo group (P < 0.01 for the interaction between time and treatment effect). For the decrease in pain scores (VAS), the differences between the 2 groups in favor of CS were already significant after one month of treatment and still significant at 3, 6, 9 months.

No significant differences were observed between the two groups in terms of consumption of acetaminophen, while a trend toward a decrease in the consumption of NSAIDs was observed in the CS group during the study.

"A significant advance in the management of knee osteoarthritis"

Prof. André KAHAN (University of Paris Descartes and Cochin Hospital, Paris, France), lead investigator of the study, underlined the high quality of radiologic assessment. "The study provides clear evidence that the highly purified CS preparation used is not only a symptomatic slow-acting drug for osteoarthritis (SYSADOA), but also, and most importantly , a disease modifying osteoarthritis drug (DMOAD).

See http://www.ibsa.ch/050409stopp_pressrelease.pdf for full press release.

4. The European GUIDE (Glucosamine Unum In Die Efficacy).

The Unum in Die Efficacy Trial found that glucosamine sulfate taken once a day may have more ability to control pain due to knee osteoarthritis than acetaminophen. In the Unum in Die study of 318 patients with symptomatic knee osteoarthritis, patients took either oral glucosamine sulfate soluble powder (1500 mg once a day), acetaminophen (1000 mg three times a day), or placebo over a 6-month period. All groups were also allowed ibuprofen as needed.
Both glucosamine sulfate and acetaminophen showed greater efficacy than placebo in reducing pain, according to the study.

Importantly, patients taking glucosamine sulfate appeared to experience more relief than did those on acetaminophen, according to the investigators.

Once-daily 1500 mg oral doses of glucosamine sulfate might be the preferred treatment for symptoms of knee osteoarthritis," reports GUIDE study author Gabriel Herrero-Beaumont, MD, director of the rheumatology department at the Jiménez Díaz Foundation - CAPIO, in Madrid, Spain. He also pointed out that "Based on these results, physicians who typically recommended acetaminophen may well find their patients gain more comfort taking glucosamine sulfate."

Note that glucosamine as either glucosamine sulfate or glucosamine hydrochloride (HCI) are effectively the same except for the carrier molecule that delivers the glucosamine. Both salts, in the pure form, deliver equally effective amounts of the desired glucosamine to joint cartilage. If there is a preference, it should be based on relative purity and economics.

5. The Mayo Clinic.

"The consensus of expert and industry opinion supports the use of chondroitin and its common partner agent, glucosamine, for improving symptoms and stopping (or possibly reversing) the degenerative process of osteoarthritis."

"Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009.

The Mayo Clinic gives chondroitin sulfate an "A" for Osteoarthritis.

"Multiple controlled clinical trials since the 1980s have examined the use of oral chondroitin in patients with osteoarthritis of the knee and other locations (spine, hips, finger joints). Most of these studies have reported significant benefits in terms of symptoms (such as pain), function (such as mobility), and reduced medication requirements (such as anti-inflammatories). However, most studies have been brief (six month duration) with methodological weaknesses. Despite these weaknesses and potential for bias in the available results, the weight of scientific evidence points to a beneficial effect when chondroitin is used for 6-24 months. Longer-term effects are not clear. Early studies of chondroitin applied to the skin have also been conducted. Chondroitin is frequently used with glucosamine. Glucosamine has independently been demonstrated to benefit patients with osteoarthritis (particularly of the knee). It remains unclear if there is added benefit of using these two agents together compared to using either alone".

See http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin/DSECTION=evidence

The Mayo Clinic gives glucosamine an "A for Osteoarthritis of the Knee and a "B" for Osteoarthritis generally.

Knee osteoarthritis (mild-to-moderate) "A"

"Based on human research, there is good evidence to support the use of glucosamine sulfate in the treatment of mild-to-moderate knee osteoarthritis. Most studies have used glucosamine sulfate supplied by one European manufacturer (Rotta Research Laboratorium), and it is not known if glucosamine preparations made by other manufacturers are equally effective. Although some studies of glucosamine have not found benefits, these have either included patients with severe osteoarthritis or used products other than glucosamine sulfate . The evidence for the effect of glycosaminoglycan polysulphate is conflicting and merits further investigation. More well-designed clinical trials are needed to confirm safety and effectiveness, and to test different formulations of glucosamine".

Osteoarthritis (general) "B"

"Several human studies and animal experiments report benefits of glucosamine in treating osteoarthritis of various joints of the body, although the evidence is less plentiful than that for knee osteoarthritis. Some of these benefits include pain relief, possibly due to an anti-inflammatory effect of glucosamine, and improved joint function. Overall, these studies have not been well designed. Although there is some promising research, more study is needed in this area before a firm conclusion can be made."

See: http://www.mayoclinic.com/health/glucosamine/NS_patient-glucosamine/DSECTION=evidence

6.The American Academy of Orthopedic Surgeons.

The American Academy of Orthopedic Surgeons notes that recent studies appear to support the idea that glucosamine and chondroitin relieve osteoarthritis pain.

"Glucosamine and Chondroitin Sulfate." American Academy of Orthopedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009.

7. Archives of Internal Medicine.

In 2003, a paper published in the Archives of Internal Medicine statistically merged and analyzed the results of several studies on glucosamine and chondroitin for osteoarthritis of the knee.3 The authors of this study found that both of these substances effectively reduced pain and improved mobility.

1 Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354(8):795-808.

2 Hocklberg MC, Clegg DO. Potential effects of chondroitin sulfate on joint swelling: a GAIT report. Osteoarthritis Cartilage, 2008;16(Suppl 3):S22-24.

 

Using JoMo/Dosage

1. Statements attributable to The American Academy of Orthopedic Surgeons:

(a) "...you may need to take the supplements (referring to glucosamine and chondroitin) for a couple of months before you see any results..."

[See: http://orthoinfo.aaos.org/topic.cfm?topic=A00189 Viewed 23 October 2009]

(b) "The American Academy of Orthopedic Surgeons adds that recent studies appear to support the idea that glucosamine and chondroitin relieve osteoarthritis pain".

[See: "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009]

2. Statements attributable to The Mayo Clinic:

(a) "The consensus of expert and industry opinion supports the use of chondroitin and its common partner agent, glucosamine, for improving symptoms and stopping (or possibly reversing) the degenerative process of osteoarthritis."

[See: "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009]

Ingredients

1 See, for example: Bruyere O, Reginster JY. Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip arthritis. Drugs Aging 2007;24(7):573-580. Clegg DO, REda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354(8):795-808. Gregory PJ, Sperry M, Wilson AF. Dietary supplements for osteoarthritis. Am Fam Physician 2008;77(2):177-184. Uebelhart D. Clinical review of chondroitin sulfate in osteoarthritis. Osteoarthritis Cartilage 2008;16 Suppl 3:S19-21. Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 2007;56(2):555-567.

2 See, for example: Tak SK, Pelletier JP, Verges J, e al. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study. Arthritis Res Ther 2007;9(6):R117. Uitterlinden EJ, KOevoet JL, Verkoelen CF, et al. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskelet Disord 2008;9:120.

3 Natural Medicines Comprehensive Database 2005, p892.

4 Kim LS, Axelrod LJ, Howard P, et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage 2006;14(3):286-294. Usha PR, Naidu MU. Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clin Drug Investig 2004;24(6):353-363. 

5 "Rheumatoid Arthritis, Role of Type II Collagen, Study." http://www.medicalnewstoday.com/articles/34461.php

6 "Oral Collagen for Rheumatoid Arthritis." Reprinted from Medical Sciences Bulletin, published by Pharmaceutical Information Associates, LTD. Accessible at http://genacolusa.com/studies.htm. Viewed July 28, 2009.

7 Trentham DE, Dynesius-Trentham RA, Orav EJ, et al. Effects of oral administration of type II collage on rheumatoid arthritis. Science 1993;261(5129):1727-1730.

8 Barnett ML, Combitchi D, Trentham DE. A pilot trial of oral type II collagen in the treatment of juvenile rheumatoid arthritis. Arthritis Rheum 1996;39(4):623-628. 

9 PDR for Nutritional Supplements p. 296.

10 Das A, Hammand TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH22 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage 2000;8(5):343-350. 

11 Leffler CT, Philippi AF, Leffler SG, et al. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med 1999;164(2):85-91. 

12 Basu A, Penugonda K. Pomegranate juice: a heart-healthy fruit juice. Nutr Rev 67(1):49-56. Seeram NP, Aviram M. Zhang Y, et al. Comparison of antioxidant potency of commonly consumed polyphenol-rich beverages in the United States. J Agric Food Chem 2008;56(4):1415-1422. Tzulker R, Glazzer I Bar-Ilan I, et al. Antioxidant activity, polyphenol content, and related compounds in different fruit juices and homogenates prepared from 29 different pomegranate accessions. J Agric Food Chem 2007;55(23):9559-9570. Wolfe KL, Kang X, He X, et al. Cellular antioxidant activity of common fruits. J Agric Food Chem 2008;56(18):8418-8426. 

13 Shukla M, Gupta K, Rasheed Z, et al. Consumption of hydrolysable tannins-rich pomegranate extract suppresses inflammation and joint damage in rheumatoid arthritis. Nutrition 2008;24(7-8):733-743.

14 Ahmed S, Wang N, Hafeez BB, et al. Punica granatum L. extract inhibits IL-1induced expression of matrix metalloproteinases by inhibiting the activation of MAP kinases and NF-B in human chondrocytes in vitro. J Nutr 2005;135:2096-2102. 

15 Jacob RA, Spinozzi GM, Simon VA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr 2003;133(6):1826-1829.

16 "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009]

17 "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009]

 

 

Athletes

1. Statements attributable to The American Academy of Orthopedic Surgeons:

(a) "...you may need to take the supplements (referring to glucosamine and chondroitin) for a couple of months before you see any results..."

[See: http://orthoinfo.aaos.org/topic.cfm?topic=A00189 Viewed 23 October 2009]

(b) "The American Academy of Orthopedic Surgeons adds that recent studies appear to support the idea that glucosamine and chondroitin relieve osteoarthritis pain".

[See: "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009]

2. Statements attributable to The Mayo Clinic:

(a) "The consensus of expert and industry opinion supports the use of chondroitin and its common partner agent, glucosamine, for improving symptoms and stopping (or possibly reversing) the degenerative process of osteoarthritis."

[See: "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009]

 

Arthritis & Weight Loss

1 "Healthy Weight - it's not a diet, it's a lifestyle! Body Mass Index." Centers for Disease Control and Prevention. Last Reviewed January 27, 2009. Accessible at http://www.cdc.gov/healthyweight/assessing/bmi/. Viewed July 6, 2009.

2 "Osteoarthritis Weight Management." The Johns Hopkins Arthritis Center. Accessible at http://www.hopkins-arthritis.org/patient-corner/disease-management/osteoandweight.html#ref10. Viewed July 14, 2009.

3 Felson DT, Zhang Y, Hannan MT, et al: Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum. 1997;40:728-733.

4 "Osteoarthritis Weight Management." The Johns Hopkins Arthritis Center. Accessible at http://www.hopkins-arthritis.org/patient-corner/disease-management/osteoandweight.html#ref10. Viewed July 14, 2009.

5 Anderson J, Felson DT. Factors associated with osteoarthritis of the knee in the First National Health and Nutrition Examination (HANES I). Am J Epidemiol 1988;128:179-189.

6 Felson DT. Weight and osteoarthritis. J Rheumatol 1995;43:7-9.

7 Felson DT, Zhang Y, Hannan MT, et al. Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum 1997;40:728-733.

8 "Arthritis Health Center: Knee Replacement Surgery." WebMD. Last updated April 20, 2007. Accessible at http://arthritis.webmd.com/knee-replacement-surgery. Viewed July 14, 2009.

9 "The Diabetes-Arthritis Connection." Arthritis Today. The Arthritis Foundation. Accessible at http://www.arthritistoday.org/conditions/other-conditions/more-conditions/diabetes-arthritis.php. Viewed July 14, 2009.

10 "Women Live Longer, Not Better, Largely Because of Obesity and Arthritis." DukeHealth.org. Accessible at http://www.dukehealth.org/HealthLibrary/News/women_live_longer_not_better_largely_because_of_obesity_and_arthritis. Viewed July 15, 2009.

 

Joint Pain & Arthritis

1 Shukla M, Gupta K, Rasheed Z, et al. Consumption of hydrolyzable tannins-rich pomegranate extract suppresses inflammation and joint damage in rheumatoid arthritis. Nutrition. Jul.-Aug. 2008;24(7-8):733-743.

2 "Bursitis." Arthritis Foundations. http://www.arthritis.org/disease-center.php?disease_id=6

3 "Prelanence." National Ffbromyaliga Association. Accessible at http://www.fmaware.org/site/PageServer?pagename=fibromyalgia_affected.. Viewed July 15, 2009

4 Bagis S, Tamer L, Sahin G, et al. Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder? Rheumatol Int 2005;25(3):188-90.

5 "Systemic Lupus Erythematosus (Lupus) (SLE)." Arthritis Foundation, 2009. Accessible at http://www.arthritis.org/disease-center.php?disease_id=29&df=whos_at_risk. Viewed July 15, 2009.

6 "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009]

7 "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009]

 

 

Active Lifestyles

1 "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009]

2 "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009]

 

Elbow

1 "Types of Arthritis." Arthritis Foundation. Accessible at http://www.arthritis.org/types-arthritis.php. Viewed June 30, 2009.

2 "Total elbow replacement for elbow arthritis." UW Medicine. Updated June 20, 2008. Accessible at http://www.orthop.washington.edu/uw/elbowreplacement/tabID__3376/ItemID__61/PageID__2/Articles/Default.aspx. Viewed June 30, 2009.

3 "Arthritis and Tennis Elbow." WebMD. Accessible at http://www.webmd.com/osteoarthritis/guide/tennis-elbow. Viewed June 30, 2009.

4 "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009.

5 "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009.

 

Ankle

1 "What is Arthritis?" Arthritis Foundation. http://www.arthritis.org/arthritis-is.php. Viewed June 25, 2009.

2 "Ankle Arthritis." Bruce Sangeorzan, M.D., ed. UW Medicine. Updated August 6, 2008. Accessible at http://www.orthop.washington.edu/anklearthritis. Viewed June 25, 2009.

3 "Osteoarthritis. What is it?" Arthritis Foundation. Accessible at http://www.arthritis.org/disease-center.php?disease_id=32. Viewed June 25, 2009

4 "Infectious Arthritis." Revised February 2008 by Steven Schmitt, M.D. The Merck Manuals Online Medical Library. Accessible at http://www.merck.com/mmhe/sec05/ch065/ch065c.html. Viewed June 25, 2009.

5 "Infectious Arthritis." Revised February 2008 by Steven Schmitt, M.D. The Merck Manuals Online Medical Library. Accessible at http://www.merck.com/mmhe/sec05/ch065/ch065c.html. Viewed June 25, 2009.

6 Felson DT: Weight and osteoarthritis. J.Rheumatol. 1995;43:7-9.

7 "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009.

8 "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009.

 

Foot

1 "Arthritis." American Podiatric Medical Association. 2009. Accessible at http://www.apma.org/MainMenu/Foot-Health/FootHealthBrochures/GeneralFootHealthBrochures/Arthritis.aspx. Viewed July 1, 2009.

2 "Arthritis Types - Overview." Centers for Disease Control. Page last reviewed June 8, 2008 . Accessible at http://www.cdc.gov/arthritis/arthritis/osteoarthritis.htm. Viewed July 1, 2009.

3 "About Lupus. The Musculoskeletal System." Lupus Foundation of America, 2008. Accessible at http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnaffects.aspx?articleid=2322&zoneid=526. Viewed July 1, 2009.

4 "Arthritis Types - Overview. Gout." Centers for Disease Control, page last reviewed June 8, 2008. Accessible at http://www.cdc.gov/arthritis/arthritis/gout.htm. Viewed July 1, 2009.

5 "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009.

6 "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009.

 

Hand and Wrist

1 Statistics for this paragraph from "Data and Statistics: Arthritis Related Statistics." National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control. Reviewed November 3, 2008. Accessible at http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistics.htm. Viewed June 29, 2009

2 Statistics for this paragraph from "Data and Statistics: Arthritis Related Statistics." National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control. Reviewed November 3, 2008. Accessible at http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistics.htm. Viewed June 29, 2009

3 Statistics for this paragraph from "Data and Statistics: Arthritis Related Statistics." National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control. Reviewed November 3, 2008. Accessible at http://www.cdc.gov/ARTHRITIS/data_statistics/arthritis_related_statistics.htm. Viewed June 29, 2009

4 "Arthritis Prevalence: A Nation in Pain." News from the Arthritis Foundation, 2005. Accessible at http://www.arthritis.org/media/chapters/ind/documents/prevalence%20fact%20sheet.pdf. Viewed June 29, 2009

5 "Arthritis Types - Overview." Centers for Disease Control. Page last reviewed June 8, 2008 . Accessible at http://www.cdc.gov/arthritis/arthritis/osteoarthritis.htm. Viewed July 1, 2009. 

6 "Osteoarthritis of the Hand." American Society for Surgery of the Hand. Viewed June 26, 2009. 

7 "Arthritis Types - Overview." Centers for Disease Control. Page last reviewed June 8, 2008 . Accessible at http://www.cdc.gov/arthritis/arthritis/osteoarthritis.htm. Viewed July 1, 2009.

8 Robinson VA, Brosseau L, Casimiro L, Judd MG, Shea BJ, Tugwell P, Wells G. Thermotherapy for treating rheumatoid arthritis. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD002826. DOI: 10.1002/14651858.CD002826.

9 "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009. 

10 "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009.

 

Hip

1. "Arthritis Types - Overview." Centers for Disease Control. Page last reviewed June 8, 2008 . Accessible at http://www.cdc.gov/arthritis/arthritis/osteoarthritis.htm. Viewed July 1, 2009.

 

Shoulder

1. "Chondroitin Sulfate." MayoClinic.com. Accessible at http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin. Viewed July 1, 2009.

2. "Glucosamine and Chondroitin Sulfate." American Academy of Orthopaedic Surgeons. Last updated July 2007. Accessible at http://orthoinfo.aaos.org/topic.cfm?topic=a00189. Viewed July 1, 2009.

 

Omega3

1. Darlington LG, Stone TW. Antioxidants and fatty acids in the amelioration of rheumatoid arthritis and related disorders. British Journal of Nutrition. Mar 2001;85(3):251-69.

2. Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. May 2007;129(1-2):210-23.

3. Kremer JM. n-3 fatty acid supplements in rheumatoid arthritis. The American Journal of Clinical Nutrition. Jan 2000;71(1 Suppl):349S-51S.
4. Supplement Guide: Fish Oil, ArthritisToday.org retrieved 9/15/09 http://www.arthritistoday.org/treatments/supplement-guide/supplements/fish-oil.php

5. Hill AM, Buckley JD, Murphy KJ, Howe PR. Combining fish-oil supplements with regular aerobic exercise improves body composition and cardiovascular disease risk factors. American Journal of Clinical Nutrition. May 2007; 85(5):1267-1274.

6. Mori T, Kondo H, Hase T, Tokimitsu I, Murase T. Dietary fish oil upregulates intestinal lipid metabolism and reduces body weight gain in C57BL/6J mice. The Journal of Nutrition. Dec 2007;137(12):2629-34.

7. Kim HK, Della-Fera M, Lin J, Baile CA. Docosahexaenoic acid inhibits adipocyte differentiation and induces apoptosis in 3T3-L1 preadipocytes. The Journal of Nutrition. Dec 2006;136(12):2965-9.

 

Diet

1 Mark "Osteoarthritis Weight Management." The Johns Hopkins Arthritis Center. Accessible at http://www.hopkins-arthritis.org/patient-corner/disease-management/osteoandweight.html#ref10. Viewed July 14, 2009.

2 Nicklas BJ, Ambrosius W, Messier SP, et al. Diet-inducted weight loss, exercise, and chronic inflammation in older, obese adults: a randomized, controlled clinical trial. Am J Clin Nutr, 2004;79(4):544-551. Selvin E, Paynter N, Erlinger TP. The effect of weight loss of C-reactive protein. Arch Intern Med 2007;167(1)31-39. Nicklas BJ, You T, Pahor M. Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training. CMAJ 2005;172(9).

3 Weiss DJ, Anderton CR. Determination of catechins in matcha green tea by micellar electrokinetic chromatography. J Chromatogr A 2003;1011(1-1):173-180.

4 Rasheed Z, Akhtar N, Anbazhagan AN, et al. Polyphenol-rich pomegranate fruit extract (POMx) suppresses PMACI-induced expression of pro-inflammatory cytokines by inhibiting the activation of MAP Kinases and NF-kappaB in human KU812 cells. J Inflamm (Lond) 2009;6:1.

5 Funk JL, Frye JB, Oyarzo JN, et al. Comparative effects of two ginger-containing Zingiber officinale extracts on experimental rheumatoid arthritis (perpendicular). J Nat Prod 2009,Feb 13. [Epub ahead of print]

6 Funk JK, Frye JB, Oyarzo JN, et al. Efficacy and mechanism of action of turmeric supplements in the treatment of experimental arthritis. Arthritis Rheum 2006;54(11):3452-3464.

7 Browning LD. "Natural Painkillers and Strong Antioxidants Found in Tart Cherries." NaturalNews.com, April 17. 2008. Accessible at http://www.naturalnews.com/023038_cherries_tart_cherries_antioxidants.html. Viewed July 25, 2009.

8 Calbom, Cherie and Keane, Maureen. Juicing For Life. Avery Trade, 1991. p.53.

9 He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet 2006;367(9507):320-326.

10 Gao YT, McLaughlin JK, Blot WJ, et al. Reduced risk of esophageal cancer associated with green tea consumption. J Nat'l Cancer Inst 1994;86(11):855-858.

11 Tokunaga S, White IR, Frost C, et al. Green tea consumption and serum lipids and lipoproteins in a population of healthy workers in Japan. Annals of Epidemiology 2002;12(3):157-65. Kono S, Shinchi K, Wakabayashi K, et al. Relation of green tea consumption to serum lipids and lipoproteins in Japanese men. Journal of Epidemiology 1996;6:128-133.

12 See, for example: Pattison DJ, Harrison RA, Symmons DP. The role of diet in susceptibility to rheumatoid arthritis: a systematic review. J Rheumatol 2004;31(7):1310-1319. Berbert AA, Kondo CR, Almendra CL, et al. Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Nutrition 2005;21(2):131-136. Linos A, Kaklamani VG, Kaklamani E, et al. Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables? Am J Clin Nutr 1999;70(6):1077-1082.

 

Exercise

1. KeeschKC, Miller YD, Brown WJ. Relationship between physical activity and stiff or painful joints in mid-aged women and older women: a 3-year prospective study. Arthritis Res Ther 2007;9(2):R34.

2. Brorsson S, Hilliges M, Sollerman C, et al. A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis. J Rehabil Med 2009;41(5):338-342.

3. Callahan LF, Physical activity programs for chronic arthritis. Curr Opin Rheumatol 2009;21(2):177-182.

4. Freburger JK, Carey TS, Holmes GM, et al. Exercise prescription for chronic back or neck pain: who prescribes it? Who gets it? What is prescribed? Arthritis Rheum 2009;61(2):192-200.

5. Coilhan, K. "Tai Chi May Ease Knee Pain." WebMD.com, 2008. Accessible at http://www.webmd.com/osteoarthritis/news/20081024/tai-chi-may-ease-knee-pain. Viewed July 16, 2009.

6. Baker KR, Nelson ME, Felson DT, et al. The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial. J Rheumatology 2008;28(7):1655-1665,

7. Thomas KS, Muri KR, Doherty M, et al. Home based exercise programme for knee pain and knee osteoarthritis: randomized controlled trial. BMJ 2002;325:752.

 

Alternate Therapies

1. Richy F, Bruyere O, Ethgen O, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Inter Med 2003;163(13):1514-1522.

2. Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354(8):795-808.

3. Hocklberg MC, Clegg DO. Potential effects of chondroitin sulfate on joint swelling: a GAIT report. Osteoarthritis Cartilage, 2008;16(Suppl 3):S22-24.

4. Oosterveld FG, Rasker JJ, Floors M, et al. Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis. A pilot study showing good tolerance, short-term improvement of pain and stiffness, and a trend towards long-term beneficial effect. Clin Rheumatol 2009;28(1):29-34.

5. Perlman AI, Sabina A, Williams AL, et al. Massage therapy for osteoarthritis of the knee: a randomized controlled trial. Arch Intern Med 2006;166(22):2533-8.

6. Long AF. The effectiveness of shiatsu: findings from a cross-European, prospective observational study. J Altern Complement Med 2008;14(8):921-30.

7. Michlovitz S, Hun L, Erasala GN, et al. Continuous low-level heat wrap therapy is effective for treating wrist pain. Arch Phys Med Rehabil 2004;85(9):1409-16.

8. Seto H, Ikeda H, Hisaoka H, et al. Effect of heat-and steam-generating sheet on daily activities of living in patients with osteoarthritis of the knee: randomized prospective study. J Orthop Sci 2008;13(3):187-91.

9. Ozgönenel L, Aytekin E, Durmusoglu G. A double-blind trial of clinical effects of therapeutic ultrasound in knee osteoarthritis. Ultrasound Med Biol 2009;35(1):44-9.

10. Johnson M, Martinson M. Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: A meta-analysis of randomized controlled trials. Pain 2007;130(1):157-165.

11. Harlow T, Greaves C, White A, et al. Randomised controlled trial of magnetic bracelets for relieving pain in osteoarthritis of the hip and knee. BMJ 2004;329(7480):1450-1454.

12. Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med 2004;141(12):901-910.

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